[Various clinical aspects of cutaneous leishmaniasis, a disease too often unrecognized in the Paris area. Diagnostic and therapeutic problems].

Muco-cutaneous leishmaniasis is now more frequently observed in France owing to population movements. One should learn to recognise the disease, the various aspects of which are presented here (7 cases). They recall the necessity of associating direct search for leishmania in the serous exsudate from the lesions or on histological sections, routine culture of swabs on agar jelly en riched with blood and on heart-brain blood medium. The immunoglobulin estimation sometimes revealed significant increase in their levels, but the sero-immunologic reactions by the indirect immuno-fluorescent method, were all negative. The best treatment is N-methylglucamine antimoniate by intradermal injection under the lesions or, in some cases, the parenteral route. On the other hand, metronidazole does not seem to be efficacious in skin leishmaniasis in this part of the world.